Cancer Control Research Program, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada.
Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
J Cancer Surviv. 2017 Jun;11(3):410-419. doi: 10.1007/s11764-017-0598-z. Epub 2017 Jan 27.
The study aims to better understand Pap test utilization for cancer survivors diagnosed before age 25 in British Columbia (BC), Canada.
A population-based cross-sectional data linkage study that included 1285 5-year female cancer survivors diagnosed with cancer before age 25 and 12,185 randomly selected and birth-year-matched BC female residents. Pap participation rates in 2008-2010, both uncorrected and corrected for hysterectomy status, were compared between two groups. Adjusted prevalence ratios (PR) were calculated to examine (1) associations between factors and Pap rates in each group and (2) interactions between factors and groups, using log-binomial regression models.
Overall Pap rates, both uncorrected and corrected, were higher for survivors (71.8%; 72.9%) than population (69%; 69.7%). Pap rates were 4.8-5.1 and 17.8-22.4% higher for survivors aged 30-39 and 50-59 respectively. Significantly higher Pap test utilization was associated with previous Pap tests (PR = 1.83, 95%CI = 1.76-1.89) and previous cervical procedures (1.20, 95%CI = 1.15-1.25). Hysterectomy rates were doubled for survivors (7.4%) than population (3.7%). This did not affect Pap participation rate comparisons between two groups. In both groups, 51.6-70% of females with hysterectomies still received Pap tests.
Survivors' Pap test utilization was significantly higher than population, but lower than the Canadian benchmark of 90%. Hysterectomy correction does not affect this observation. Cervical cancer screening is suboptimal for survivors. Females with prior hysterectomies might have received unnecessary Pap tests.
Survivors without prior hysterectomies should continue to undergo Pap tests recommended by provincial guidelines, to optimize their health.
本研究旨在更好地了解加拿大不列颠哥伦比亚省（BC）25 岁以下诊断为癌症的女性癌症幸存者的巴氏涂片检查利用率。
这是一项基于人群的横断面数据链接研究，纳入了 1285 名 5 年内诊断为 25 岁以下癌症的女性癌症幸存者和 12185 名随机选择且出生年份匹配的 BC 女性居民。比较了两组在 2008-2010 年未校正和校正子宫切除状态的巴氏涂片参与率。使用对数二项式回归模型计算调整后的患病率比（PR），以检查（1）两组中各因素与巴氏涂片率的关系和（2）因素与组之间的相互作用。
校正和未校正的总体巴氏涂片率，幸存者组均高于人群组（分别为 71.8%和 72.9%；69%和 69.7%）。30-39 岁和 50-59 岁的幸存者巴氏涂片率分别高 4.8-5.1 和 17.8-22.4%。以前的巴氏涂片检查（PR=1.83，95%CI=1.76-1.89）和以前的宫颈检查（1.20，95%CI=1.15-1.25）与巴氏涂片检查利用率显著增加相关。幸存者的子宫切除术率（7.4%）是人群的两倍（3.7%）。这并未影响两组之间巴氏涂片参与率的比较。在两组中，51.6-70%的子宫切除术女性仍接受巴氏涂片检查。
幸存者的巴氏涂片检查利用率明显高于人群，但低于加拿大 90%的基准。校正子宫切除术并不影响这一观察结果。宫颈癌筛查对幸存者来说并不理想。以前接受过子宫切除术的女性可能接受了不必要的巴氏涂片检查。
没有子宫切除术的幸存者应继续按照省级指南进行巴氏涂片检查，以优化其健康状况。
